Pre-diabetes is a condition where a person’s blood glucose levels are higher than normal but not high enough to be diagnosed as type 2 diabetes.  It’s important to know if you have pre-diabetes, because if you do you’re at a 10 to 20 times higher risk of going on to develop type 2 diabetes. But it’s also important to know that, with the right changes to your lifestyle, diabetes can be delayed or even prevented.  That’s why it’s important to recognise the warning signs of pre-diabetes. What is pre-diabetes? Glucose is the body’s main source of energy. When we eat or drink, glucose enters our bloodstream, causing the pancreas to release the hormone insulin, which controls the amount of glucose in the blood. This is vital as most of the cells in our body can only function when our glucose levels stay within a certain range.  If the insulin isn’t working properly and a person has a condition called insulin resistance, the amount of glucose in the blood can rise to the level that is described as pre-diabetes.

Pre-diabetes—risk factors and symptoms

To be diagnosed with pre-diabetes, your blood glucose levels must be:
  • Higher than normal (more than 7.8 mmol/L) and;
  • Not high enough to be diagnosed as type 2 diabetes (less than 11.1 mmol/L).
It’s likely that some people have a genetic disposition to pre-diabetes (this means you are more likely to get pre-diabetes because of your family history), but its exact cause is unknown. There are, however, risk factors.  Risk factors The risk factors for pre-diabetes are very similar to those for type 2 diabetes. They can be split into two groups, modifiable (meaning that they can be changed) and non-modifiable (meaning that they can’t be changed). Modifiable (changeable) risk factors include:
  • Being overweight—this is a major risk factor for pre-diabetes. The more fat you carry, especially around your waist, the more your cells become resistant to insulin. This risk factor increases after the age of 55.
  • Having an unhealthy diet. 
  • Being physically inactive.
  • Having high triglycerides (blood fats) and low HDL-C (‘good’ cholesterol) and/or high LDL-C (‘bad’ cholesterol).
  • Having high blood pressure, especially if you are over 45.
  • Having poor sleep patterns.
  • Smoking.
Non-modifiable (unchangeable) risk factors include:
  • Age—although pre-diabetes can develop at any age, the risk of prediabetes increases after age 55.
  • Ethnicity—although it’s unclear why, people with a family background of Aboriginal and Torres Strait Islander, Pacific Islander, South-East Asian, Asian (the sub-continent), Arabic, or north African are more likely to develop pre-diabetes. This risk increases in people who are over 35.
  • Having a parent or sibling with pre-diabetes or type 2 diabetes.
  • Women with Polycystic Ovarian Syndrome (PCOS).
  • Women who have had diabetes in pregnancy (gestational diabetes) or given birth to a big baby (more than 4.5kgs).
Symptoms Pre-diabetes often has no signs or symptoms (apart from, possibly, darkened skin on the neck, armpits and groin). However, hyperglycaemia, which causes pre-diabetes, does have symptoms. These include:
  • frequently needing to urinate
  • increased thirst and frequent urination
  • weight loss
  • blurry vision
  • infections.
If you have any of the above, it’s a good idea to see your doctor.

Pre-diabetes: diagnosis and treatment

It is recommended that adults check their diabetes risk every three years from the age of 40 years using the Australian type 2 diabetes risk assessment tool. Annual screening from 18 years of age is recommended for Aboriginal and Torres Strait Islander peoples. As there are no reliable signs or symptoms of pre-diabetes, it is usually diagnosed when a person’s doctor is concerned that they have the symptoms of high blood glucose levels listed above and sends them for a blood test. The test to confirm pre-diabetes and diabetes is a fasting glucose test (FGT)/blood glucose test. This is where a blood sample is taken to show the level of glucose in your blood after fasting (not eating or drinking anything other than water) for 8-10 hours. If the results suggest pre-diabetes, your doctor will ask you to have an oral glucose tolerance test (OGTT). The level of glucose in your blood is checked after fasting for 8-10 hours. You then have a glucose drink and another blood sample is taken after 1 or 2 hours. This test shows how your body responds to glucose. Your doctor may then ask you to take an HbA1c test. This is useful for diagnosing pre-diabetes and diabetes as it checks your average blood glucose level over the past three or four months. If pre-diabetes is confirmed, it means you have one or both of the following conditions:
  • impaired glucose tolerance — your blood glucose level is above normal but not high enough to be diagnosed as diabetes
  • impaired fasting glucose — your fasting blood glucose level is above normal but not high enough to be diagnosed as diabetes.
A diagnosis of pre-diabetes does not mean that you’ll automatically develop type 2 diabetes. Making healthy changes to your lifestyle such as eating well, doing regular physical activity and maintaining a healthy weight can prevent type 2 diabetes. As pre-diabetes also increases the risk of heart disease, it is important to manage your blood pressure and cholesterol. It is also important to quit smoking if you smoke.  Without making lifestyle changes, a person with pre-diabetes is at high risk of going on to develop type 2 diabetes.

Type 2 diabetes

Type 2 diabetes is a condition where the body resists the normal effects of insulin and gradually becomes unable to produce enough of it. It is the most common type of diabetes, and almost 1.3 million Australians are currently living with type 2 diabetes. Type 2 diabetes can be prevented or delayed by making healthy lifestyle changes, such as losing weight, eating healthy foods and being active.  The symptoms of type 2 diabetes include:
  • increased thirst and frequent urination
  • blurry vision
  • tiredness
  • feeling hungry
  • having cuts that heal slowly.
It is important to diagnose and treat type 2 diabetes in order to prevent serious long-term complications such as:
  • heart disease
  • kidney disease
  • stroke
  • eye problems
  • peripheral nerve damage.


Finding out if you have prediabetes and treating it early is important. If you have any of the signs or symptoms of hyperglycaemia, you should see a doctor.  Managing pre-diabetes by making healthy lifestyle choices can help you avoid getting type 2 diabetes.  So how can the Life! program help you make healthy lifestyle choices?  The Life! program will give you all the support, resources and knowledge you need.  Life! is a free healthy lifestyle program that helps you improve your eating habits, increase your physical activity and manage stress. You can choose from a group course or our telephone health coaching service. Our experienced health professionals will help you make changes to your lifestyle so that you can successfully manage pre-diabetes. Since 2007, over 75,000 Victorians have learnt more about living a healthy life with the Life! program. It is the largest prevention program of its kind in Australia. Life! is funded by the Victorian government and managed by Diabetes Victoria. You can take a quick online health test and check your eligibility for the program here Take the health check Sources,%E2%80%94%20a%20type%20of%20fat%20in%20your%20blood


Kristie Cocotis, Head of Prevention and Health Promotion Sarah Dubé, Strategy and Engagement Lead Ria Cheripuram, Digital Communications Officer Tegan Kohlman, Communications and Social Marketing Officer Iftu Umar, Program facilitator and Health Coach